De Quervain’s Stenosing Tenosynovitis

De Quervain’s stenosing tenosynovitis is a condition that affects the two tendons on the side of the wrist that control the sideways movement of the thumb. This tendon passes through a tunnel (the first dorsal compartment). The lining on the tendon secretes a fluid which allows the tendon free gliding. In de Quervain’s, this tissue becomes inflamed, causing the tendon to glide less freely, which leads to irritation and eventually pain and tenderness.

Causes

De Quervain’s tendinitis is caused when tendons on the thumb side of the wrist are swollen or irritated. The irritation causes the lining (synovium) around the tendon to swell, which changes the shape of the compartment. This makes it difficult for the tendons to move as they should.

Tendinitis may be caused by overuse. It can be seen in association with pregnancy. It may be found in inflammatory arthritis, such as rheumatoid disease. De Quervain’s tendinitis is usually most common in middle-aged women.

Symptoms

Signs of De Quervain’s tendinitis:

  • Pain may be felt over the thumb side of the wrist. This is the main symptom. The pain may appear either gradually or suddenly. Pain is felt in the wrist and can travel up the forearm. The pain is usually worse when the hand and thumb are in use. This is especially true when forcefully grasping objects or twisting the wrist.
  • Swelling may be seen over the thumb side of the wrist. This swelling may occur together with a fluid-filled cyst in this region.
  • A “catching” or “snapping” sensation may be felt when moving the thumb.
  • Pain and swelling may make it difficult to move the thumb and wrist.
  • Numbness may be experienced on the back of the thumb and index finger. This is caused as the nerve lying on top of the tendon sheath is irritated.

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